VS4 Test 4

-Type of toxin
-How much toxin?
-Amount of time between ingestion and intervention
-Health condition prior to ingestion
-Age of animal
-Species

-Prevent further exposure
-Prevent further absorption
-Quickly eliminate toxin
-Supportive therapy

Ingestion

Inhalation,
Injection-snake bite, spider bite
Ocular
Topical

-Find out as much info as possible
-Tell owner behavior may be altered, so they may need to protect themselves
-Protect animal from further exposure
-Ask client to bring in a sample of the toxin
-Bring recent sample of urine, feces, vomit
-Bring animal to the clinic IMMEDIATELY

Rinse the eyes, preferably with PSS

May or may not give steroids depending on if ulcers are present. No steroids if there are ulcers.
-Antibiotics, NSAIDS

-Bathe animal with mild soap
-Avoid topical ointments-these may hold possible toxic residue against skin which will enhance absorption
-Use PPE
-Consider the possibility of ingestion from topical exposure

-Induce emesis
-Gastric lavage
-Activated charcoal
-Cathartic medications

-If animal is seizing
-Dyspnea
-Hypoxia
-Lack of normal pharyngeal reflex
-Ingestion of caustic substances or unknown substances
-Household cleaners common, are alkaline

-Ipecac syrup-more effective in cats
-H2O2
-Apomorphine
-Xylazine
-Quick IV bolus of cephazolin-great in cats
-At home w/o H2O2- a 1:8 liquid dishsoap:water

Used when emesis is contraindicated or large amounts of toxin was ingested.

Within 2-4 hours of ingestion

-Animal is lightly sedated
-Measure from tip of the nose to 13th rib and mark tube
-lubricate tube
-Advance into esophagus then stomach slowly
-Pump fluid in, siphon out, repeat until clear
-put activated charcoal in stomach via tube
-kink tube and remove

Attracts drugs, toxins, chemicals and binds them thereby preventing absorption.

Due to enterohepatic recirculation, toxins may end up back in the stomach from the liver--->gallbladder--->small intestines

agents that promote clearing of intestines

Given with Activated charcoal about 30 minutes after charcoal. the combination binds toxins and promotes clearing while decreasing the constipation associated with Activated charcoal.

-Animals with diarrhea
-neonates
-geriatrics

-stimulate evacuation by increasing fecal volume

examples; Psyllium, methylcellulose, bran, Metamucil

Act by softening feces and reducing friction

example: Mineral oil

Increase H2O contest in intestines, indirectly increases motility

examples: Milk of magnesia, epsom salt

-Increase peristalsis

example: Dulcolax

methylxanthines

Dark chocolate
coffee
colas
---caffeine
-Milk chocolate (44mg/oz.)
-baking chocolate (300mg/oz)

250-500mg/kg

-Overstimulation of CNS----HYPER!!!
-Cardiotoxicity
-renal failure
-Anxiousness
-Ataxia,
-muscle tremors
-Tachycardia/cardiac arrythmias--can lead to sudden death
-Urinary incontinence, hematuria
-Abdominal pain
-Seizures, coma

**history
-C/S
-Presence of xanthines in urine

-Induction of emesis
-Gastric lavage, charcoal
-Urinary catheter-xanthines can be reabsorbed by bladder

-1st generation has a 14hrs half life with effects that last about a week

-2nd generation-has a 4-6 day half-life with effects that last about a month

Mineralization of soft tissues, typically kidneys, GI tract, heart

-Try to induce vomiting
-Activated charcoal
-Diuresis Fluid overload
-Calcitonin--will block calcium uptake

-Brain death due to cerebral edema

C/S-Tremors, seizures, recumbancy

Death within 10-24 hours
Tx-NONE

-Usually occur 1-2 days after ingestion
-Lethargy
-V/D
-Anorexia
-Ataxia
-Hemorrhage, melena, bruising, pale, MM
-Dyspnea

-History
-Prolonged bleeding times
-Response to vitamin K therapy

-Induce vomiting
-Activated charcoal
-Whole blood transfusions if indicated
-Oral vitamin K (mixed with canned food that has a higher fat content will increase absorption)

Their inability to biotransform acetaminophen to a usable nontoxic form.
-Cat's liver does not produce enzymes that will break it down into non-toxic metabolites.

Causes the conversion of hemoglobin on RBC's to methemaglobin which cannot carry O2.

50-60mg/kg

* 2 doses w/in 24 hrs will kill a cat

-Vomiting
-Salivation
-facial and paw edema
-tachypnea
-dyspnea
-muddy brown MM and urine

150-200mg/kg

Hepatic damage/necrosis

-Lethargy
-Anorexia
-Vomiting
-Abdominal pain

--Induce vomiting
-ANTIDOTE: N-acetylcysteine (mucomist) 140mg/kg bolus then 70mg/kg IV or PO q6hrs for 7 treatments
-Cimetidine-helps inhibit liver damage
-Vitamin C - antioxident

ANTIFREEZE
-Color film processing chemicals
-Brake fluids
-Rust remover
-Industrial solvents
-Snow globes

6.6ml/kg

1.5ml/kg

CNS depression, Vomiting, ataxia, PU/PD, sizures, coma, renal failure-oliguria, azotemia, death

Causes severe metabolic acidosis
. Increases Ion gap/difference

1) INGESTION to 30 minutes to 12 hours. C/S-Ataxic, V/nausea, possible seizures and death with large doses
2) 12 TO 24 HOURS post ingestion- C/S Tachypnea, tachycardia, subtle signs
3) 24 TO 72 HOURS post ingestion- renal failure-PU/PD, urea and BUN up, anorexia, vomiting
CNS depression

-C/S
-Blood work-will show metabolic acidosis
-Colormetric test-tests for ethyl glycol in blood
-Woods lamp test-urine and blood both florece if ethyl glycol has been ingested

-Emesis
-Gastric lavage
-20% ethanol solution-acts as a competitive inhibitor to prevent further absorption
-4-methapyrazole- same as Ethanol but works more quickly. $$$ compared to ethanol.
-Sodium bicarbonate-takes care of metabolic acidosis
-Dialysis
-supportive care
-PROGNOSIS-usually favorable if treatment is w/in 6-8 hours in dogs, 3 hours in cats

-Will see 2 fang marks rather than 2 rows of multiple teeth
-Edema at bite site
-Pain
-Respiratory distress
-hypotensive
-shock
-nausea, vomiting,
eventual renal failure
-tissue necrosis

-Pain at the bite
-Inject neurotoxin
**ABDOMINAL RIGIDITY W/O TENDERNESS
-muscle rigidity/cramps
-respiratory difficulties
-Vomiting, dizziness
-paralysis
-cats- may die due to paralysis of diaphragm

--Bite not painful at time animal was bitten, animal may not know it was bitten
-Bite injects a digestive enzyme
-Itching at site
-Bleb or blister at site
**RED, WHITE BLUE LESION AT SITE**
-Fever, nausea
-Tissue,necrosis that may become infected
-Voided urine may be pink to red in color
-

-Antivenin
-Benedryl
-analgesics
+/- muscle relaxants
-respiratory support

-Clean wound and keep it clean
-Supportive care
-analgesics-necrosis is painful
+/- antibiotics to prevent secondary infection
-Possible surgical excision
-O2 therapy directly over the wound

Causing a rapid increase in blood insulin levels which results in a rapid decrease in blood glucose levels

-Ataxia
-Weakness
-Depression
-hypoglycemia
-hypokalemia
-Seizures
-Coma
-Severe cases-possible brain damage, liver dysfunction and/or failure

-As little as 0.15/kg can cause toxic signs
-as little as 5 pieces of gum can kill a 65lb dog

-Induce vomiting
-Oral dextrose/sugar to combat hypoglycemia
-IV dextrose
-IV potassium for hypokalemia
-Monitor liver fxn

Acute cardiovascular collapse that results in sudden and severe drop in BP, decrease in IV volume. This deprives the organs and tissues of oxygen and allows the buildup of waste products.

-Pale MM
-Icteric membranes
-Tachycardia
-Cold extremities
-Weak thready pulse
-Depressed mental state, stupor
-loss of coordination

Shock due to a minor trauma
-Normal to bounding pulses
-**HYPER-RESPONSIVE CRT, less than 1 sec
-Mentation normal to slightly anxious
-HR normal to slightly anxious
-Can progress to decompensated shock

Results from acute blood loss or loss in BP that is too great for bodies compensatory systems to resolve
-W/in 30 seconds, sympathetic NS kicks in
-tachycardic
-decrease in BP
-Possible increase in CRT
-peripheral vasoconstriction
-splenic contracture
-kidneys conserve water, secrete renin which is hormone that increase bp

The final phase of shock. An hindsight diagnosis typically. the length of time that poor perfusion has existed begins to take a permanent toll on the body's organs and tissues. The heart's functioning continues to spiral downward, and the kidneys usually shut down completely. Cells in organs and tissues throughout the body are injured and dying and this results in death.

-Hypovolemic
-Neurogenic
-Cardiogenic shock
-Endotoxic/septic

Due to blood volume decrease, due to hemorrhage, severe dehydration, widespread vasodialation.

Attributed to head/brain trauma. There is a loss in BP but not blood volume.

Due to severe heart failure, shock resulting from inadequate cardiac function associated with acute myocardial infarction and congestive heart failure typically.
-Pale MM, blood not being returned to heart
-# Cool extremities
# Variable heart rate and respiratory rate
# Harsh lung sounds and crackles
# Cough
# Weak pulse
# Muscle weakness
# Mental dullness
# Cardiac decompensation may be associated with a history of previously compensated heart disease and cardiac drug administration

Mass vasodialation due to bacterial toxins
-Pale MM
hypothermia, tachycardia and muscle weakness